| NPI | 1518946052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 003650) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NC 4631) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2007-07-08 |